Vicarious traumatization and secondary traumatic stress: A research synthesis∗

TLDR

Vicarious traumatization and secondary traumatic stress are harmful changes and psychological symptoms arising from exposure to clients’ trauma, yet the literature lacks conceptual clarity, hindering practice and training. This study clarifies the definitions of VT and STS and synthesizes research findings using a levels‑of‑evidence analysis. The authors re‑designed the study from a planned meta‑analysis to a levels‑of‑evidence synthesis, reviewing English‑language research and dissertations from 1994–2003 to assess evidence for factors contributing to VT and STS. Evidence shows personal trauma history strongly predicts both VT and STS, perceived coping style and supervision experiences moderately predict VT, and exposure to trauma material strongly predicts STS. The study discusses its limitations and proposes directions for future research.

Abstract

Vicarious traumatization (VT) refers to harmful changes that occur in professionals' views of themselves, others, and the world, as a result of exposure to the graphic and/or traumatic material of their clients. Secondary traumatic stress (STS) refers to a set of psychological symptoms that mimic post-traumatic stress disorder, but is acquired through exposure to persons suffering the effects of trauma. Numerous studies have sought to identify correlates of both VT and STS, yet there still exists a lack of conceptual clarity in the literature about VT, STS, and the related constructs of burnout and compassion fatigue. This has made it difficult to use the literature to inform practice and training. This study clarifies the definitions of VT and STS and uses levels of evidence analysis to synthesize the research findings to date. Originally planned as a meta-analysis, the study was re-designed as methodological issues in the literature became apparent that would call into question the validity of a meta-analysis. The current method of analysis documents the degree of evidence for the most commonly researched factors that have been researched as possible contributors to the development of both VT and STS, synthesizing the findings of published research and dissertations written in the English language from 1994–2003. Findings indicate that persuasive evidence exists for personal trauma history, reasonable evidence for perceived coping style, and some evidence for supervision experiences, as important predictors of VT. Persuasive evidence for amount of exposure to trauma material and reasonable evidence for personal trauma history are indicated as important in the development of STS. Limitations of the current study and directions for further research are discussed.